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General NPI Number Information
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NPI Number | 1750814919
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Entity Type | Individual
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Provider Name | JUDY YI NP
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Gender | Female
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Dates
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Enumeration Date | 04/05/2017
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Last Update Date | 05/13/2020
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Provider Practice Location Address
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Address Line | 1361 ESTEL DR
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City | POMONA
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State | CA
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Zip | 91768-2361
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Country | US
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Telephone | 909-868-8547
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Fax |
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Provider Business Mailing Address
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Address Line | 1361 ESTEL DR
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City | POMONA
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State | CA
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Zip | 91768-2361
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Country | US
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Telephone | 909-868-8547
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 95006221
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 95006221
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 364SA2100X
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Taxonomy Name | Acute Care Clinical Nurse Specialist
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License Number | 95006221
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 95006221
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License Number State | CA
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